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Year 4 - Mental Health > Psychosis > Flashcards

Flashcards in Psychosis Deck (11)
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1
Q

Name the 4 main types of symptom characteristic of psychosis.

A
  1. delusions
  2. hallucinations
  3. formal thought disorder
  4. disorders of the self
2
Q

define ‘delusion’

A
  • fixed belief (usually false) that is firmly held despite evidence to the contrary and that is out of keeping with the person’s sociocultural norms.
  • can be further classified into e.g. grandiose, persecutory, hypochondriacal, reference, guilt
3
Q

define ‘hallucination’

A
  • perception in the absence of an external stimulus

- can be in any of the 5 modalities: auditory (most common in psychosis), visual (most common in delirium), olfactory…

4
Q

define ‘formal thought disorder’

A

impairment in ability to form thoughts from logically connected ideas - speech is incoherent with sentences/phrases/words not following on from each other

5
Q

define ‘disorders of the self’

A
  • impairment of aspects of the self that include distinguishing self and other, continuity in time, self as agent, self as unity of experience and self as private space
  • includes symptoms such as though broadcast/insertion/withdrawal
6
Q

suggest possible risk factors for schizophrenia

A
  • FHx
  • birth complications: low birthweight, premature labour, asphyxia during birth
  • older age of father
  • prenatal infections, e.g. maternal influenza A in 2nd trimester
  • frequent use of cannabis
  • trauma, loss, stress
7
Q

describe 3 possible pathophysiological causes of schizophrenia

A
  1. dysregulation of dopaminergic activity: increased in mesolimbic pathway (+ve symptoms) and decreased in prefrontal cortical pathway (-ve symptoms)
  2. structural brain changes: enlarged lateral and 3rd ventricles, decreased volume of hippocampus and amygdala
  3. altered glucose metabolism: decreased glucose in prefrontal cortex
8
Q

names examples of -ve symptoms of SZP

A

i. Avolition (decreased ability to initiate purposeful activity)
ii. Anhedonia (decrease interest and motivation)
iii. Alogia (poverty of speech)
iv. flattened Affect
v. Attention deficits
vi. self-neglect

9
Q

name the 1st rank symptoms of SZP

A

i. auditory hallucinations: running commentary, 3rd person, audible thoughts
ii. delusional perceptions
iii. thought insertion, withdrawal, broadcasting
iv. somatic passivity
v. made feelings, made impulses, made acts

10
Q

describe the different types of SZP

A
  1. PARANOID SZP: relatively stable delusions, usually paranoid, hallucinations and perceptual disturbances predominate
  2. CATATONIC SZP: psychomotor disturbances predominate (may alternate between stupor, automatic obedience, negativism, violent excitement)
  3. HEBEPHRENIC SZP: dominated by affective changes, social isolation, irresponsible and unpredictable behaviour
  4. SIMPLE SZP: -ve symptoms predominate, insidious progressive dev. of conduct abnormalities, inability to meet demands of society and decline in total performance
  5. UNDIFFERENTIATED SZP
11
Q

how would you manage a patient presenting with first episode psychosis?

A
  1. oral antipsychotic (usually atypical) +
  2. psychological intervention (family intervention and individual CBT)
  3. If unresponsive, trial a different antipsychotic (at least 1 should be a 2nd generation non-clozapine antipsychotic) at adequate dose.
  4. Offer clozapine